Safe and appropriate use of insulin and other antihyperglycemic agents in hospital.

Ensuring safe and appropriate use of antihyperglycemic agents in hospital is a challenge. It requires that the contraindications and precautions to the use of non-insulin agents be observed, the incidence of hypoglycemia and severe hyperglycemia be minimized, and the risk of medication errors (including inappropriate prescribing) be reduced. Insulin is a high-alert medication with an increased risk for causing patient harm when prescribed inappropriately or administered in error.

Audit of antibiotic duration of therapy, appropriateness and outcome in patients with nosocomial pneumonia following the removal of an automatic stop-date policy.

Automatic stop-orders (ASOs) have been utilized to discourage inappropriately prolonged antibiotic therapy. An ASO policy, which required reordering of antibiotics after 7 days of therapy, had been in place at our institution prior to 2002, but was revoked after instances of compromised patient care due to inadvertent and inappropriate interruption of antimicrobial treatment. The objective of this study was to evaluate the impact of revoking the ASO policy on the duration of antibiotic therapy, infection-related outcome (cure vs failure), relapsing infection, occurrence of resistant bacteria and superinfection in patients with nosocomial pneumonia.

Investing in heart-healthy children: a primary prevention innovation in Atlantic Canada.

Inactivity and unhealthy eating are precursors to the development of coronary artery disease. In Atlantic Canada, there is a widely recognized escalation of obesity and Type 2 diabetes in children. Our multidisciplinary group developed a three-year program targeting children in grades 4, 5 and 6 in an effort to alter this debilitating life course.